Neutrons can be generated in medical linear accelerators (Linac) due to the interaction of high-energy photons (> 10 MeV) with the components of the accelerator head. The generated photoneutrons may penetrate the treatment room if a suitable neutron shield is not used. This causes a biological risk to the patient and occupational workers. The use of appropriate materials in the barriers surrounding the bunker may be effective in preventing the transmission of neutrons from the treatment room to the outside. In addition, neutrons are present in the treatment room due to leakage in the Linac's head. This study aims to reduce the transmission of neutrons from the treatment room by using graphene/hexagonal boron nitride (h-BN) metamaterial as a neutron shielding material. MCNPX code was used to model three layers of graphene/h-BN metamaterial around the target and other components of the linac, and to investigate its effect on the photon spectrum and photoneutrons. Results indicate that the first layer of a graphene/h-BN metamaterial shield around the target improves photon spectrum quality at low energies, whereas the second and third layers have no significant effect. Regarding neutrons, three layers of the metamaterial results in a 50% reduction in the number of neutrons in the air within the treatment room.
The thermoluminescence (TL) glow curves and kinetics parameters of Thulium (Tm) doped silica cylindrical fibers (CF) are presented. A linear accelerator (LINAC) was used to deliver high-energy radiation of 21MeV electrons and 10MV photons. The CFs were irradiated in the dose range of 0.2-10Gy. The experimental glow curve data was reconstructed by using WinREMS. The WinGCF software was used for the kinetic parameters evaluation. The TL sensitivity of Tm-doped silica CF is about 2 times higher as compared to pure silica CF. Tm-doped silica CF seems to be more sensitive to 21MeV electrons than to 10MV photons. Surprisingly, no supralinearity was displayed and a sub-linear response of Tm-doped silica CF was observed within the analyzed dose range for both 21MeV electrons and 10MV photons. The Tm-doped silica CF glow curve consists of 5 individual glow peaks. The Ea of peak 4 and peak 5 was highly dependent on dose when irradiated with photons. We also noticed that the electron radiation (21MeV) caused a shift of glow peak by 7-13°C to the higher temperature region compared with photons radiation (10MV). Our Tm-doped fibers seem to give high TL response after 21MeV electrons, which gives around 2 times higher peak integral as compared with 10MV photon radiation. We concluded that peak 4 is the first-order kinetic peak and can be used as the main dosimetric peak of Tm-doped silica CF.
Percentage depth doses for 6 and 10 MV x-ray beams from a linear accelerator were measured using approximately 1 cm long (approximately 0.3 mg) Ge-doped optical fibre as a thermoluminescence dosimeter for two field sizes, 5 x 5 and 10 x 10 cm2. The results indicate that the Ge-doped optical fibre dosimeter is in good agreement with the results from a PTW 30001 cylindrical ionisation chamber and TLD-100. For 6 MV x-ray beams we observe that the depth of maximum dose d(max) is 1.5 and 2 cm for field sizes of 5 x 5 and 10 x 10 cm2 respectively. For 10 MV d(max) is 2 cm for a field size of 5 x 5 cm2 and 2.5 cm for a 10 x 10 cm2 field.
Estimation of the surface dose is very important for patients undergoing radiation therapy. The purpose of this study is to investigate the dose at the surface of a water phantom at a depth of 0.007 cm as recommended by the International Commission on Radiological Protection and International Commission on Radiation Units and Measurement with radiochromic films (RFs), thermoluminescent dosemeters and an ionisation chamber in a 6-MV photon beam. The results were compared with the theoretical calculation using Monte Carlo (MC) simulation software (MCNP5, BEAMnrc and DOSXYZnrc). The RF was calibrated by placing the films at a depth of maximum dose (d(max)) in a solid water phantom and exposing it to doses from 0 to 500 cGy. The films were scanned using a transmission high-resolution HP scanner. The optical density of the film was obtained from the red component of the RGB images using ImageJ software. The per cent surface dose (PSD) and percentage depth dose (PDD) curve were obtained by placing film pieces at the surface and at different depths in the solid water phantom. TLDs were placed at a depth of 10 cm in a solid water phantom for calibration. Then the TLDs were placed at different depths in the water phantom and were exposed to obtain the PDD. The obtained PSD and PDD values were compared with those obtained using a cylindrical ionisation chamber. The PSD was also determined using Monte Carlo simulation of a LINAC 6-MV photon beam. The extrapolation method was used to determine the PSD for all measurements. The PSD was 15.0±3.6% for RF. The TLD measurement of the PSD was 16.0±5.0%. The (0.6 cm(3)) cylindrical ionisation chamber measurement of the PSD was 50.0±3.0%. The theoretical calculation using MCNP5 and DOSXYZnrc yielded a PSD of 15.0±2.0% and 15.7±2.2%. In this study, good agreement between PSD measurements was observed using RF and TLDs with the Monte Carlo calculation. However, the cylindrical chamber measurement yielded an overestimate of the PSD. This is probably due to the ionisation chamber calibration factor that is only valid in charged particle equilibrium condition, which is not achieved at the surface in the build-up region.
The ultimate check of the actual dose delivered to a patient in radiotherapy can be achieved by using dosimetric measurements. The aims of this study were to develop and evaluate a custom handmade head and neck phantom for evaluation of Three-Dimensional Conformal Radiation Therapy (3D-CRT) dose planning and delivery. A phantom of head and neck region of a medium built male patient with nasopharyngeal cancer was constructed from Perspex material. Primary and secondary Planning Target Volume (PTV) and twelve Organs at Risk (OAR) were delineated using Treatment Planning System (TPS) guided by computed tomography printout transverse images. One hundred and seven (107) holes distributed among the organs were loaded with Rod-shaped Thermoluminescent dosimeters (LiF:Mg,Ti TLDs) after common and individual calibration. Head and neck phantom was imaged, planned and irradiated conformally (3D-CRT) by linear accelerator (LINAC Siemens Artiste). The planned predicted doses by TPS at PTV and OAR regions were obtained and compared with the TLD measured doses using the phantom. Repeated TLD measurements were reproducible with a percent standard deviation of < 3.5%. Moreover, the average of dose discrepancies between TLDs reading and TPS predicted doses were found to be < 5.3%. The phantom’s preliminary results have proved to be a valuable tool for 3D-CRT treatment dose verification.
This work evaluated and compared the absorbed doses to selected organs in the head and neck region from the three image guided radiotherapy systems: cone-beam computed tomography (CBCT) and kilovoltage (kV) planar imaging using the On-board Imager® (OBI) as well as the ExacTrac® X-ray system, all available on the Varian Novalis TX linear accelerator. The head and neck region of an anthropomorphic phantom was used to simulate patients' head within the imaging field. Nanodots optically stimulated luminescent dosemeters were positioned at selected sites to measure the absorbed doses. CBCT was found to be delivering the highest dose to internal organs while OBI-2D gave the highest doses to the eye lenses. The setting of half-rotation in CBCT effectively reduces the dose to the eye lenses. Daily high-quality CBCT verification was found to increase the secondary cancer risk by 0.79%.
Improvements in delivery of radiation dose to target tissues in radiotherapy have increased the need for better image quality and led to a higher frequency of imaging patients. Imaging for treatment planning extends to function and motion assessment and devices are incorporated into medical linear accelerators (linacs) so that regions of tissue can be imaged at time of treatment delivery to ensure dose distributions are delivered as accurately as possible. A survey of imaging in 97 radiotherapy centres in nine countries on six continents has been undertaken with an on-line questionnaire administered through the International Commission on Radiological Protection mentorship programme to provide a snapshot of imaging practices. Responses show that all centres use CT for planning treatments and many utilise additional information from magnetic resonance imaging and positron emission tomography scans. Most centres have kV cone beam CT attached to at least some linacs and use this for the majority of treatment fractions. The imaging options available declined with the human development index (HDI) of the country, and the frequency of imaging during treatment depended more on country than treatment site with countries having lower HDIs imaging less frequently. The country with the lowest HDI had few kV imaging facilities and relied on MV planar imaging intermittently during treatment. Imaging protocols supplied by vendors are used in most centres and under half adapt exposure conditions to individual patients. Recording of patient doses, a knowledge of which is important in optimisation of imaging protocols, was limited primarily to European countries.
Short course hypo-fractionated radiotherapy is a standard regime for the palliation of stage IV head and neck cancers. However few patients respond favorably and require further radiotherapy in curative intent. We have used split-course radiotherapy technique to find out this conversion rate from palliative to curative intent. This was a prospective study conducted from November 1998 to October 1999; twenty-six (26) patients with stage IV head & neck cancers were treated with a hypofractionated regime of radiotherapy. A tumor dose of 30 Gy in 10 fractions [time dose fraction (TDF) 62] over 2 weeks was delivered using a 6 MV linear accelerator. A conventional 2 field or 3 field technique was used. Patients were assessed for the regression of tumor on fifth day, tenth day of radiotherapy and 4 weeks after the completion of radiotherapy. Patients showing complete response and good partial response were allowed to receive further radiotherapy of 30 Gy in 15 fractions [TDF 49]. There were 21 males and 5 females in the study with a median age of 44 years (range 19-77 years). All patients completed the initial regime. Complete responses were observed among 14 patients (54%); partial response in 6 patients (23%), and no response was seen among 6 patients (23%). Sixteen patients (61%) were suitable for radical radiotherapy after phase-I course of the above schedule. Seventeen patients (65%) showed an improvement in the general well being with a better quality of life. One year actuarial survival was (76%), with a median survival time of 12 months. Split-course technique is a useful radiotherapy treatment in stage IV head and neck cancers to distinguish between the subset of patients who would require curative treatment and who would not.